Provider Demographics
NPI:1083100622
Name:LEE, DANIEL CHANG-KYOU (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHANG-KYOU
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 E BOOT RD STE 600B
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5968
Mailing Address - Country:US
Mailing Address - Phone:610-430-8272
Mailing Address - Fax:
Practice Address - Street 1:1450 E BOOT RD STE 600B
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5968
Practice Address - Country:US
Practice Address - Phone:610-430-8272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD481688208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery